Risk factors for prevalence of and mortality related to restriction on spirometry: findings from the First National Health and Nutrition Examination Survey and follow-up

• Published in: The international journal of tuberculosis and lung disease Vol. 9; no. 6; pp. 613 - 621
• Main Authors: MANNINO, D. M, HOLGUIN, F, PAVLIN, B. I, FERDINANDS, J. M
• Format: Journal Article
• Language: English
• Published: Paris, France IUATLD 01.06.2005; Union internationale contre la tuberculose et les maladies respiratoires
• Subjects: Adult; Aged; Biological and medical sciences; Chronic obstructive pulmonary disease, asthma; Cohort Study; Comorbidity; Death; Female; Follow-Up Studies; Forced Expiratory Volume; Humans; Logistic Models; Lung Function; Male; Medical sciences; Middle Aged; Pneumology; Prevalence; Proportional Hazards Models; Respiration Disorders - epidemiology; Respiration Disorders - mortality; Restriction On Spirometry; Risk Factors; Spirometry; United States - epidemiology; Vital Capacity; United States; North America; America; Human; Spirometry; Prognosis; Prevalence; Respiratory disease; Health; Mortality; Exploration; restriction on spirometry; Epidemiology; Lung function; Follow up study; Cohort study; Risk factor; Death
• ISSN: 1027-3719; 1815-7920

OBJECTIVE: To define risk factors for both restriction on spirometry and subsequent mortality in a national cohort of US adults.METHODS: Participants in the First National Health and Nutrition Examination Survey (NHANES I) were followed for up to 22 years. Subjects were classified using the forced expiratory volume in one second (FEV1), the forced vital capacity (FVC), and the FEV1/FVC ratio into subgroups with and without restriction on spirometry. Regression models were developed to determine risk factors for restriction on spirometry and death.RESULTS: Our final cohort consisted of 4320 subjects, of whom 481 (10.3 weighted %) had restriction on spirometry. The largest risk factors for restriction on spirometry were a cardiothoracic ratio of >55% (OR 4.3, 95%CI 3.1-5.9), race other than black or white (OR 3.7, 95%CI 1.8-7.8), and a history of stroke or paralysis (OR 1.8, 95%CI 1.1-2.9). The overall mortality rate was increased in subjects with restriction on spirometry (25.7 vs. 10.3 deaths per 1000 person-years).CONCLUSIONS: Restriction on spirometry is associated with comorbid disease and increased mortality, and is present in a significant proportion of the population.